scholarly journals Ultrasound-Guided Percutaneous Neuromodulation in Patients with Unilateral Anterior Knee Pain: A Randomized Clinical Trial

2020 ◽  
Vol 10 (13) ◽  
pp. 4647
Author(s):  
Paula García-Bermejo ◽  
Blanca De-la-Cruz-Torres ◽  
Carlos Romero-Morales
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Knee Flexion ◽  
Femoral Nerve ◽  
Single Shot ◽  
Ultrasound Guided ◽  
Symptomatic Knee ◽  
Anterior Knee

The objective of this study was to evaluate the short-term and crossover effects of a percutaneous neuromodulation (PNM) intervention on the femoral nerve, regarding the pain, knee flexion motion (range of motion (ROM)), and functionality, in patients with unilateral anterior knee pain (AKP). Our study used a randomized clinical trial design. Thirty patients were divided into two groups: one asymptomatic knee group in which patients received stimulation in the femoral nerve corresponding to the nonsymptomatic knee; and one symptomatic knee group, in which patients received stimulation in the femoral nerve corresponding to the painful knee. Pain, knee flexion ROM, Victorian Institute of Sport Assessment-Patella (VISA-P) and Kujala questionnaires were evaluated. Twenty-eight patients completed the study. Compared to their baseline values, both groups showed an increase immediately at 24 h, and at 1 week for the knee flexion ROM variable. In addition, the symptomatic knee group showed an increase for the Kujala score and a decrease for the numeric rating scale (NRS) variable from baseline to 1 week. VISA-P score did not show statistically significant differences for the time-group interaction. After the intervention, there were no differences between the groups in any measured time. Conclusion: a single-shot ultrasound-guided PNM intervention per week in the femoral nerve may be an effective treatment for improving the pain, knee flexion ROM, and knee functionality. In addition, this technique produces crossover benefits in the nonintervention limb.

scholarly journals Effect of ultrasound-guided percutaneous neuromodulation applied to the femoral nerve on pain and range of motion in patients with anterior knee pain: A case study

2020 ◽  
Vol 03 (01) ◽  
pp. 030-034
Author(s):  
Paula García-Bermejo ◽  
Carlos Romero-Morales ◽  
Blanca de-la-Cruz-Torres
Keyword(s):  
Range Of Motion ◽  
Knee Pain ◽  
Effect Size ◽  
Anterior Knee Pain ◽  
Femoral Nerve ◽  
Medium Effect ◽  
Ultrasound Guided ◽  
Symptomatic Knee ◽  
Single Intervention ◽  
Anterior Knee

Abstract Introduction Anterior knee pain (AKP) is one of the most frequent reasons for physical therapy consultations, remaining a difficult treatment challenge for professionals. The aim of this study was to evaluate the effects of an intervention using ultrasound-guided percutaneous neuromodulation (US-guided PNM) applied to the femoral nerve on pain and knee flexion range of motion (ROM), in patients with unilateral chronic anterior knee pain. Methods Eight patients received a single intervention of NMP-e on the femoral nerve of the symptomatic knee. The level of pain and ROM were measured before, immediately after and 24 hours after the intervention. Results A decrease in pain and an increase of ROM were observed after the intervention and at 24 hours. For pain values, a medium effect size was observed (ES = 0.63 ± 0.43) after the intervention, and a large effect size (ES = 1.73 ± 0.44) was found at 24h. Concerning ROM, the effect size was large at both moments (ES = − 1.30 ± 1.14; −1.76 ± 0.80, respectively). Conclusion A single intervention of US-guided PNM on the femoral nerve produces a decrease of pain and increases the ROM, which is greater 24h after the stimulation. Level of Evidence Level II-3.

The effect of adding myofascial techniques to an exercise programme for patients with anterior knee pain – A randomized clinical trial

2016 ◽  
Vol 25 ◽  
pp. e151-e152
Author(s):  
G. Telles ◽  
D. Cristovão ◽  
F. Belache ◽  
M. Santos ◽  
R. Almeida ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Exercise Programme ◽  
Anterior Knee

scholarly journals Application of ultrasound-guided percutaneus neuromodulation (PNM) in women with anterior knee pain

2019 ◽  
Vol 02 (02) ◽  
pp. 072-072
Author(s):  
García-Bermejo P. ◽  
Albornoz-Cabello M. ◽  
De la Cruz-Torres B.
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Post Intervention ◽  
Phase Duration ◽  
Affected Side ◽  
Significant Difference ◽  
Anterior Knee ◽  
Experimental Group

Abstract Background Anterior knee pain (AKP) is one of the most common pathologies of the lower limb, with an incidence that is 2.2% greater in women than in men. Electric currents have been used as an effective treatment for pain in many pathologies, however, the percutaneous application of the same has represented a particularly great advancement. In the field of physical therapy, ultrasound-guided percutaneous neuromodulation (US-guided PNM), is a technique that is being developed with promising results, however there is still a scarcity of studies concerning this technique. Aim To evaluate the improvement in chronic anterior knee pain symptoms after the application of US-guided PNM on the femoral nerve of the affected side or the healthy side, in a population of women. Material and Methods The sample comprised 15 women with chronic unilateral AKP, who were randomly divided into two groups: experimental group 1 (n = 8), who received US-guided PNM upon the femoral nerve, on the leg of the affected side, and an experimental group 2 (n = 7), who received US-guided PNM on the femoral nerve of the non-affected side. The intervention was performed using a needle measuring 0.3 × 40mm on the motor fibers of the femoral nerve under ultrasound guidance and using a monopolar electrode, with a frequency of 10 Hz and a phase duration of 250 microseconds, during 1.5 minutes. We registered active ROM in both knees, pain according to the Visual Analog Scale (VAS) and functionality using the VISA-P questionnaire and the Kujala scale. All variables were evaluated pre-intervention, post-intervention and after 24 hours. Results No statistically significant differences were found in both groups between the pre and post intervention measurements. However, statistically significant changes were found in both groups between the pre and post intervention at 24 hours, regarding increased ROM and functionality and a decrease in pain (p < 0.05). Nonetheless, the between-group comparison did not obtain a significant difference in any of the variables studied (p > 0.05). The measurement of the effect size obtained a large clinical effect between both groups and between the pre-intervention measurement and the assessment at 24 hours. Conclusion Treatment of chronic AKP in women, using US-guided PNM, leads to an improvement of symptoms and functionality, 24 hours after application of the same, regardless of whether it is applied on the femoral nerve of the affected leg or on that of the healthy leg.

Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain?

2017 ◽  
Vol 51 (1) ◽  
pp. 1-6
Author(s):  
S Arumugam ◽  
Tvisha Ketan Parikh
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Knee Flexion ◽  
Tertiary Care ◽  
Biomechanical Analysis ◽  
Categorical Variables ◽  
Odds Ratios ◽  
Stratified Analysis ◽  
The Impact ◽  
Anterior Knee

ABSTRACT Aim To evaluate the association between anterior knee pain (AKP) and traditional Indian habits of cross-legged sitting and squatting which involve deep knee flexion. Materials and methods A case control study was carried out in 225 patients and 225 age and sex matched controls at a tertiary care university hospital in South India over 3 years. Males and females between 18 and 55 years were evaluated using a clinical proforma of history and musculoskeletal examination. The details of deep knee flexion habits with quantification of duration were noted and participants were categorized into those who sat and did not sit cross legged, and squatters and nonsquatters. Odds ratios and chi-square tests were calculated for both these categorical variables. A subgroup analysis and stratified analysis were also performed. Results The Odds ratios for cross-legged sitting and squatting were not significant at 0.88 and 0.92 respectively. Sixty-nine point three percentage of the AKP cases and 72% of the controls sat cross legged (p = 0.534) and 67.6% of the AKP cases and 69.3% of controls habitually squatted (p = 0.685). Stratified analysis revealed a protective effect of cross legged sitting in AKP cases with quadriceps muscle tightness. Conclusion This study did not find an association between AKP and Indian habits of deep knee flexion. More than 65% of all the participants regularly engaged in these habits. Laboratory biomechanical analysis of these positions is suggested in future to understand their effect on knee joint. Clinical significance These positions are integral to daily habits of many Indians. The advice to AKP patients to avoid them due to their probable AKP association is not supported by the current study. Clinicians can consider the impact on the patient's quality of life before advising against these positions. How to cite this article Parikh TK, Arumugam S. Are Indian Habits of Cross-legged Sitting and Squatting associated with Anterior Knee Pain? J Postgrad Med Edu Res 2017;51(1):1-6.

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